Organization
ASSOCIATES IN EYE CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY WALTER UPCHURCH OD (PRESIDENT AND AUTHORIZED OFFICIAL)
(606) 387-5612
Entity
Organization
Contact information
Practice address
467 SUNSET TRAIL, JELLICO, TN 37762-2709
(423) 784-2020
(423) 784-4940
Mailing address
127 FOOTHILLS AVE, SUITE 3, ALBANY, KY 42602-1090
(606) 387-5612
(606) 387-6602
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
174791
BLUECARE/TENNCARE/BCBSTN--GROUP
TN
01
—
3941098
MEDICAID # FOR DR. ERIC TODD OVERLEY
TN
05
—
3941346
—
TN
01
—
3946891; 3946892
MEDICARE PIN FOR DR. STEPHEN MCKINLEY
TN
05
—
3946892
—
TN
01
—
4104981
BLUECARE/TENNCARE/BCBSTN--GROUP
TN
01
—
4209308
BLUECARE/TENNCARE/BCBSTN
TN
01
—
62079
OPTUMHEALTH VISION
—
05
—
7100209950
—
KY
05
—
77902641
—
KY
01
—
AO0136:001
EYEMED
—
01
—
CJ5379
RAILROAD MEDICARE
TN
01
—
K217560
MEDICARE
KY
Enumeration date
09/27/2006
Last updated
03/22/2021
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